‘Inhuman to not let kin be with Covid-19 patients’

Allow relatives to be with Covid19 patients This central health ministry guideline has been overlooked in Maharashtra resulting in scores of victims of the virus being forced to put up a lonely fight a doctor from Sevagram has said Dr Indrajit Khandekar a professor of Forensic Medicine at MGIMS went a step ahead by not wearing the PPE kit to ensure a human touch with Covid19 patientsMost hospitals keep the kin away from patients citing government norms ldquoThis is inhuman and cruelrdquo said Dr Khandekar pitching for making interaction of relatives with patients and medical staff a part of treatment protocols ldquoInteracting with relatives can be extremely therapeutic and can give a patient the desire to survive in the most difficult situationsrdquo he saidDr Khandekar headed a Covid19 unit of Kasturba hospital attached to MGIMS between April 17 and May 3 He treated about 90 patients with just an N95 maskLoneliness can make even nonserious patients lose hope and refuse treatment particularly those struggling to manage chores like using the washroom eating and drinking ldquoSome disoriented patients remove oxygen masks and urinate on the floor Such patients need continuous help and itrsquos not possible for any healthcare worker to provide thatrdquo he saidAlso Read Maharashtra Tribal belt battles an unknown killerLanguage can also be a barrier said Dr Khandekar adding the Centrersquos guidelines clearly talk of all these aspectsldquoWhen a Covid19 patient dies it is impossible to resolve the doubts of the family members It is ruthless not to give relatives a chance to say goodbye to them while they are still aliverdquo said Dr Khandekar He added ldquoPPE lowers my confidence and I cant do the job assigned to me properly That doesnrsquot mean Irsquom carelessrdquoHowever not all experts agree with Dr KhandekarDr Santosh Bansode Head of the Department of Emergency Medicine at Wockhardt Hospital Mumbai Central said the guidelines are clear about who can manage without a PPE kit ldquoAnyone coming in direct contact with patients should wear full PPE and not just an N95 mask and gloves They include Isolation centresrsquo holding area and triage staffrdquo He said since doctors in chambers need to examine patients they must wear the gears ldquoEven after wearing full PPE sometimes doctors and healthcare workers get infected Why take a chancerdquo said Dr BansodeOn the allowing relatives Dr Bansode said ldquoI have read the guidelines point by point and I am of the belief that no visitors or attendants should be allowed with admitted Covid19 patients I understand that patients with Covid19 need emotional support but that can be given with frequent video calls by relatives to patientsrdquo He said that since most patients get discharged after five days itrsquos better not to expose relatives to the hospital environment ldquoCurrently we are facing a second wave so we must not take any riskrdquoDr Rajesh Dhere dean of BKC Covid19 centre and also the head of Forensic Medicine and Toxicology at Sion hospital said ldquoIt is highly risky to examine patients in Covid19 wards without PPE kits and other mandatory gears because the virus can get fixed to clothes and even skin Knowingly or unknowingly the said doctor can get infected and spread the virusrdquoDr Dere agreed that the presence of relatives can make a positive change for patients ldquoBut no one can be sure about how a patient would react after spotting his loved one next to him The chances of emotional outburst cannot be ruled out and it can affect other patients toordquoPsychologistsrsquo takeAccording to psychotherapist Dr Shivangi Pawar it is not possible for the hospital staff to calm down every patient and a family member could accelerate healing ldquoHowever it must be assured that adequate safety precautions are taken by the hospital and the visitor Adopting strict protocols might prevent undesired disputes between hospitals and visitorsrdquo she saidExpert viewDr Subhash Hira Professor of Global Health at the University of WashingtonSeattle the Centrersquos norms also allow hospitals to provide services as per available resources and needs He talked of some states letting relatives be with patients with protective gears and a clear understanding of the risk of transmission and its consequences to them and the community ldquoHowever this arrangement compromises the principles of barriernursing required for a respiratory infectious disease and therefore other states have engaged psychologists to fill up the needs of counseling It is a tradeoff between demand and supply of servicesrdquoDr Hira added ldquoIt is highly desirable to capture experience of personal care by relatives yet ensuring protection from transmission as we prepare for a third wave sometime in AugustSeptemberrdquoThe other sideDr T P Lahane Director of Directorate of Medical Education and Research and the nodal officer in charge of statersquos Covid19 task force said ldquoA forensic surgeon can do clinical patient care but he needs to wear PPE kits and other safety gears before entering Covid19wards as the doctor may get infected and become a carrierrdquoOn relatives in Covid19 wards Dr Lahane said ldquoRelatives with Covid19 patients can speed up recovery but chances of the relative getting infected is also high Hence we do not allow relatives to visit Covid19 patientsrdquo